The psychological downside of labeling obesity a “disease”

The American Medical Association’s “disease” label appears to boost feelings of self-acceptance among obese people — but it may also undermine weight-loss efforts, a recent study suggests.

Study participants who read an article labeling obesity as a disease were less concerned about eating well than participants, choosing higher calories sandwiches.

Public-health messages that obesity is a “disease” may have significant positive and negative psychological effects, a recent study found.

While the delineation reduced feelings of shame and boosted self-esteem in obese study participants, those who were exposed to the “disease” label and similar messages placed less importance on dieting, reported less concern about weight, and chose less healthy food options — all downsides, according to the study authors.

“A disease-based … weight-management message weakened the importance placed on health-focused dieting and reduced concerns about weight among obese individuals — the very people whom such public-health messages are targeting,” reported Crystal L. Hoyt, a study co-author and psychological scientist from the University of Richmond. Because this led to higher-calorie food choices, the researchers concluded that the disease label had “negative implications … for self-regulation.”

The study, originally published in November 2013 in the journal Psychological Science and updated in April, was inspired by the American Medical Association’s official declaration last year that obesity is a “multi-metabolic and hormonal disease state.”

“On its surface, this seemed like a good move: Calling obesity a disease provides a clear warning of the significant health risks associated with excessive weight. And the obesity-is-a-disease message sparked attention, funding, and research aimed at finding medically driven remedies.

“We wondered, however, if there also might be psychological ramifications inherent in that message. Would it reduce or add to the burden of body-image concerns and shame? Would it empower people to fight back, or lead to a fatalistic acceptance of being overweight?”

Coyt and her team performed three studies of more than 700 people that involved asking participants to read one of three messages: a newspaper article about the AMA’s decision to label obesity a disease; an informational public-health message about weight-loss goals in general that did not mention whether obesity is or is not a disease; or an article specifically stating that obesity is not a disease.

The participants, who were classified as either “average weight” or “obese” based on their body mass indexes and World Health Organization guidelines, then answered questions relating to health, weight, weight loss, and eating behavior. The participants were also asked to select a sandwich from a menu with options ranging from 230 to 980 calories.

According to the researchers, obese participants who read the “obesity is a disease” article reported feeling less interested in “health-focused dieting” and less concerned about weight than participants who read one of the other two articles. They also selected higher-calorie sandwiches.

“Suggesting that one’s weight is a fixed state — like a long-term disease — made attempts at weight management seem futile, and thus undermined the importance that obese individuals placed on health-focused dieting and concern for weight,” Hoyt and Burnette concluded. “Calling obesity a disease may make people feel better about their bodies, but it also may contribute to the maintenance, rather than reduction, of obesity.”

The researchers said the ideal public-health message would boost self-esteem while also encouraging dieting and other weight-loss efforts.

Tell us: Do you believe that practicing self-acceptance is “fatalistic” and bound to lead to unhealthy choices? Does self-acceptance mean giving up, or can it lead to positive, healthy actions? Share your thoughts in the comments, on Facebook, or via Twitter @ExperienceLife.

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